Our Health and Welfare clients undergo many challenges in search of ways to deal with increasing healthcare costs, regulatory compliance, and a demand for more robust data to make better informed decisions. Below are examples of how Rael & Letson consultants have responded to those challenges:
1. Prescription Benefit Management
The cost and utilization of specialty drugs have sky rocketed over the past five years and now comprise over 50% of overall drug spend for many health plans. In fact, hemophilia-related treatments through specialty drugs can cost up to $250,000 annually and over $1 million if complications arise. By having a deep understanding of the prescription benefit management (PBM) industry, our firm was able to procure an expensive specialty medication to treat hemophilia though a lower costing alternative distribution channel saving our clients over 50% versus the traditional PBM pricing. Can this carve-out approach work for your health and welfare plan?
Avoidable emergency room visits are the bane of any health plan’s existence. In fact, according to a recent study, avoidable emergency room visits cost the U.S healthcare system an additional $32 billion. After several educational campaigns that proved ineffective, one client was looking for an answer. We recommended telemedicine. After the first year, telemedicine utilization was well over 40% reducing avoidable emergency room visits by 50%, as well as urgent care and primary care visits. Telemedicine is no longer an amenity for health plans but rather a necessity. We can find the right telemedicine vendor for your health and welfare plan.